Firefighters have a high risk of developing cardiovascular and mental disorders due to their physical and chemical environments. However, in Korea, few studies have been conducted on environmental risk of firefighters. The Firefighter Research on the Enhancement of Safety and Health (FRESH) study aimed to discover the risk factors for cardiovascular disease and mental disorders among firefighters. Former and current firefighters were recruited from three university hospitals. A total of 1022 participants completed baseline health examinations from 2016 to 2017. All participants were scheduled for follow-ups every 2 years. Baseline health survey, laboratory testing of blood and urine samples, blood heavy metal concentration, urine polycyclic aromatic hydrocarbons (PAHs) metabolites, stress-related hormone test, natural killer cell activity, as well as physical and mental health examinations that focused on cardiovascular and mental disorders, were conducted. In addition, 3 Tesla (3T) brain magnetic resonance imaging (MRI) and neuropsychological tests were also performed to investigate structural and functional changes in the brains of 352 firefighters aged >40 years or new hires with less than 1 year of service.

Background/Objectives: Stressors occurring across the life course are considered to have a cumulative impact on health, but there is no instrument for assessing lifetime stressor exposure in Korea. Therefore, we validated the Stress and Adversity Inventory (Adult STRAIN) in Korean. Methods: We translated the Adult STRAIN into Korean and examined its concurrent, predictive, and comparative predictive validity in 218 Korean adults (79 men, 139 women; M_age = 29.5; 19–50 years old) recruited from a psychiatric setting. We assessed concurrent validity using Pearson’s correlations, predictive validity using multiple regression models, and comparative predictive validity using multivariate logistic regression to identify participants with lifetime psychiatric diagnoses. Results: The Korean STRAIN exhibited sufficient usability and acceptability; good concurrent validity with other measures of early adversity, life events, and perceived stress (rs = 0.48–0.61); and strong predictive validity in relation to anxiety and depressive symptoms (β = 0.08–0.47; ΔR2 = 0.11–0.21). Each domain of Korean-style stress, based on the timing, type, life domain, and sociopsychological characteristics of stress exposure, showed a different distribution of lifetime psychiatric diagnosis probabilities (odds ratios = 1.20–4.85). Finally, the test–retest reliability for total lifetime stressor count and severity over four weeks was high. Conclusions: The Korean STRAIN is a practical, valid, and reliable instrument for researchers and clinicians to efficiently assess lifetime stressor exposure.

Background: Carotid intima-media thickness (IMT) is a noninvasive surrogate marker of subclinical atherosclerosis and cardiovascular disease risk. This study explored IMT distribution across three carotid artery segments in a large cohort of healthy individuals and identified the key factors associated with increased IMT. Methods: This study utilized data from the Kangbuk Samsung Health Study, a cohort of South Korean adults aged ≥ 18 years who underwent comprehensive annual or biennial health examinations. The analysis included 86,351 healthy individuals, excluding those with known carotid disease. IMT was measured using high-resolution B-mode ultrasonography across the three segments: common carotid artery (CCA), carotid bulb, and internal carotid artery (ICA). An increased IMT was defined as a measurement of ≥1.5 mm in any segment. Multivariable linear regression analyses were conducted to identify independent predictors of increased IMT. Results: The study population had a mean age of 46.7 years and was predominantly male (69.7%). The prevalence of thickened IMT was the highest in the carotid bulb, followed by the ICA and CCA. IMT increased progressively with age and was higher in males across all segments, with the disparity becoming more pronounced after 65 years of age. The carotid bulb displayed the largest absolute IMT values, whereas the ICA exhibited a sharper age-related increment. Increased CCA IMT was strongly linked to hypertension (beta, 0.11; p < 0.001) and diabetes mellitus (beta, 0.12; p < 0.001). Both CCA and ICA IMT showed a weak but significant association with dyslipidemia (beta, 0.03; p < 0.001). Conclusions: The IMT distribution and its determinants vary across carotid segments. CCA is a robust marker of systemic vascular health, whereas the carotid bulb is the most sensitive marker for detecting early atherosclerotic changes. This study provides novel insights into segment-specific IMT patterns and their association with cardiovascular risk factors in a large, healthy Asian population.

Background/Objectives: Stressors occurring across the life course are considered to have a cumulative impact on health, but there is no instrument for assessing lifetime stressor exposure in Korea. Therefore, we validated the Stress and Adversity Inventory (Adult STRAIN) in Korean. Methods: We translated the Adult STRAIN into Korean and examined its concurrent, predictive, and discriminate validity in 218 Korean adults (79 men, 139 women; Mage=29.5; 19–50 years old) recruited from a psychiatric setting. We assessed concurrent validity using Pearson’s correlations, predictive validity using multiple regression models, and discriminant validity using multivariate logistic regression to identify participants with lifetime psychiatric diagnoses. Results: The Korean STRAIN exhibited exceptional usability and acceptability; excellent concurrent validity with other measures of early adversity, life events, and perceived stress (rs=0.477–0.614); and strong predictive validity in relation to anxiety and depressive symptoms (β=0.08–0.47; ΔR2=0.109–0.206). The Korean STRAIN also significantly discriminated participants with psychiatric disorder based on stressor exposure timing, type, life domains, and social-psychological characteristics (odds ratios=1.20–4.85). Finally, the test–retest reliability for total lifetime stressor count and severity over four weeks was outstanding. Conclusions: The Korean STRAIN is a practical, valid, and reliable instrument for researchers and clinicians to efficiently assess lifetime stressor exposure.

Background/Objectives: Childhood trauma is a well-established risk factor for adult psychopathology, yet the underlying neuropsychiatric mechanisms remain unclear. Therefore, this study examined whether resilience mediates the relationship between childhood trauma and depressive and anxiety symptoms, and whether this pathway is moderated by harm avoidance (HA). Methods: A total of 218 Korean adults (aged 19–50 years; 79 men and 139 women) completed validated measures of childhood trauma (Childhood Trauma Questionnaire (CTQ)-Short Form), harm avoidance (Temperament and Character Inventory–Harm Avoidance subscale), resilience (Brief Resilience Scale), depression (Patient Health Questionnaire-9), and anxiety (Generalized Anxiety Disorder-7). Mediation and moderated mediation models were tested using structural equation modeling, and indirect effects were estimated via bootstrapping with 5000 resamples. Results: Childhood trauma was associated with lower resilience, an effect moderated by HA. Resilience was strongly inversely associated with depression and anxiety. Indirect effects of trauma through resilience were significant for both outcomes, with stronger effects at higher HA. Conclusions: The associations between childhood trauma and both depression and anxiety were mediated by resilience, and this indirect pathway was amplified by HA. These findings suggest a neuropsychiatric mechanism whereby early-life stress and temperament jointly shape effective neural vulnerability, leading to depression- and anxiety-associated outcomes.